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Molina Healthcare Business Analyst (Payment Policy) in Georgia

JOB DESCRIPTION

Job Summary

Analyzes complex business problems and issues using data from internal and external sources to provide insight to decision-makers. Assist with HTML, CSS and Javascript coding. Reviewing medical records and verifying reimbursements are configured and submitted correctly. Verifies medical billing and coding meet state and federal medical regulations.

KNOWLEDGE/SKILLS/ABILITIES

  • Provides analytical, problem solving foundation including: definition and documentation, specifications.

  • Recognizes, identifies and documents changes to existing business processes and identifies new opportunities for process developments and improvements.

  • Reviews, researches, analyzes and evaluates all data relating to specific area of expertise. Begins process of becoming subject matter expert.

  • Conducts analysis and uses analytical skills to identify root cause and assist with problem management as it relates to state requirements.

  • Analyzes business workflow and system needs for conversions and migrations to ensure that encounter, recovery and cost savings regulations are met

  • Prepares high level user documentation and training materials as needed.

JOB QUALIFICATIONS

Required Education

Associate's Degree or equivalent combination of education and experience

Required Experience

  • 3-5 Years of business analysis

  • 4+ years managed care experience

  • Demonstrates familiarity in a variety of concepts, practices, and procedures applicable to job-related subject areas.

Preferred Education

Bachelor's Degree or equivalent combination of education and experience

Preferred Experience

  • 1-3 years formal training in Business Analysis and/or Systems Analysis

  • HTML, CSS, and JavaScript coding skills

  • Experience reviewing medical records.

  • Medical reimbursement knowledge

  • Billing and coding expertise

  • Familiarity with state and federal medical regulations

  • Strong writing abilities and SharePoint proficiency

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $26.19 - $51.06 / HOURLY

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

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